Malaria: host-pathogen interactions, immunopathological complications and therapy.

P E Van Den Steen, K Deroost, N Geurts, H Heremans, J Van Damme, G Opdenakker
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Abstract

Malaria is a global tropical disease causing more than 1 million deaths and 300 million clinical cases every year. It is caused by parasites from the genus Plasmodium and is transmitted by Anopheles mosquitoes. Approximately 3 billion people live in malaria-endemic regions and a majority of them are infected. In this review, we discuss the life cycle of the parasite, the complex interactions with the human host and the ensuing immune reactions and complications. The immune system plays a dual role in malaria, by providing life-saving immunity against the parasite, but also by causing often lethal complications in a number of patients. Cytokines, chemokines and proteases are key players in the immunopathological complications, and we propose immunomodulation with dexamethasone as a promising strategy for the therapy of malaria-associated acute respiratory distress syndrome.

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疟疾:宿主-病原体相互作用,免疫病理并发症和治疗。
疟疾是一种全球性热带疾病,每年造成100多万人死亡和3亿临床病例。它是由疟原虫属的寄生虫引起的,由按蚊传播。大约30亿人生活在疟疾流行地区,其中大多数人受到感染。在本文中,我们讨论了寄生虫的生命周期,与人类宿主的复杂相互作用以及随之而来的免疫反应和并发症。免疫系统在疟疾中起着双重作用,一方面提供挽救生命的抗寄生虫免疫,另一方面在一些患者中引起往往致命的并发症。细胞因子、趋化因子和蛋白酶是免疫病理并发症的关键因素,我们建议用地塞米松进行免疫调节,作为治疗疟疾相关急性呼吸窘迫综合征的一种有希望的策略。
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